Categories
Accounting

Healthcare Accounting in Miami

Gustavo A Viera CPA are expert Healthcare Accounting in Miami providing a wide variety of HealthCare Accounting financial Management Services

Healthcare Accounting in Miami Services for doctors, dentists, healthcare professionals and healthcare related businesses. Our services are designed to simplify the process for you by providing comprehensive accounting, tax and financial management services. Gustavo A Viera CPA has over 25 years of being Healthcare Accounting in Miami focusing on healthcare professionals and their businesses.

Our Healthcare Accounting in Miami have always been involved with Healthcare Accounting in Miami in some capacity. Our first job was in the Chartroom for a local hospital.  As Healthcare Accountants in Miami  we feel that we could provide value by speaking to physicians in their own language and having significant knowledge of Health Care Accounting. Over the past 25 years our Healthcare Accounting in Miami commitment to healthcare has grown stronger as the economic changes have forced the healthcare industry to look past their primary objective, that of providing care, to that of earning a living.

Our Healthcare Accounting in Miami expertise will aid the preparation of a tax return and especially AHCA Cost Report. Tax & Medicare laws are very complicated and filled with exceptions to every rule. Most clients do not know if the return is wrong or right, and it may not matter since defending an audit, even if you are 100% correct, can cost you thousands of dollars. In many cases, different Healthcare Accountants in Miami will see things differently and arrive at different conclusions based on the facts of your return. The most important thing is that YOU understand what is on your return. The IRS & AHCA have increased the fines and penalties for return errors and it is becoming increasingly more complicated to prepare a return or AHCA Cost Report.

We’ve had clients, who prepare their own AHCA Cost Report., come to him after the AHCA has suspended billing during a review.

Our Healthcare Accounting in Miami services are performed by healthcare accountants. With Gustavo A Viera CPA you can be assured that your Healthcare Accounting in Miami team has significant, relevant experience with healthcare providers like you. Your Healthcare Accounting in Miami team will consist of individuals who spend virtually all of their professional time serving the healthcare industry – not manufacturing, retail or other industries.

Viera provides audit and Healthcare Accounting in Miami services to healthcare entities ranging in size from small physician practices and ancillary providers to multi-state integrated healthcare organizations with assets in excess of $1 billion. This experience across the spectrum of healthcare allows our Healthcare Accountants to quickly identify the financial reporting areas of greatest risk to your organization and to more efficiently and effectively perform audit or accounting services. Further, our Healthcare Accounting teams are structured to allow our senior executives more time with our clients in order to provide the “hands on” experience and oversight.

The following is a partial listing of the types of Healthcare Accounting in Miami services Gustavo A Viera CPA offers our clients:

  • Audits, reviews, and compilations of financial statements
  • Audits in accordance with Government Auditing Standards and OMB Circular A-133
  • Internal control reviews and risk assessments
  • Impairment testing of intangible assets
  • Agreed-upon procedure reports and special reporting
  • Transaction accounting assistance, including allocation of purchase price
  • New accounting standard implementation
  • Forensic accounting and dispute resolution
  • Outsourcing of internal audit functions
  • Accounting policy and procedure manual development

As Healthcare Accounting in Miami focused on serving the healthcare industry (over 75% of our revenues are healthcare related), we have available the resources to supplement the extensive knowledge of our Health Care Accountants through the use of our dedicated reimbursement, clinical and healthcare tax departments. Our relationships with lending institutions, bond underwriters and rating agencies are such that Viera is a nationally recognized Healthcare Accountant  in connection with debt issues.

Our Healthcare Accounting services in Miami consults practices and healthcare related businesses at every stage of the business cycle across the spectrum of medical specialties and allied fields. We work with you to increase revenues, reduce costs and enhance client/patient satisfaction.

Categories
Medicare

Healthcare Accountants in Miami

Healthcare Accountants in Miami

Healthcare Accountants in Miami, Gustavo A. Viera CPA, stated that the Centers for Medicare and Medicaid Services announced on August 10, 2011 that it will begin sending revalidation requests by mail to nearly 1.5 million health professionals, more than half of whom are physicians. These notifications are already being sent and will continue until March 23, 2013.

CMS has implemented new screening criteria for all Medicare applications in an effort to weed out individuals and institutions that shouldn’t have billing privileges, according to VieraCPA Healthcare Accountants in Miami. There is, however, a great concern expressed by many physician organizations that legitimate physicians and other Healthcare Agency professionals could mistakenly get caught up in this enrollment sweep, according to VieraCPA Home Healthcare Accountants.

We aren’t joking about checking your mail, says VieraCPA Healthcare Accountants in Miami. Once you receive the request, you will have sixty days to recertify your enrollment information. CMS is playing hardball: “Failure to submit the enrollment forms as requested may result in a deactivation of your Medicare billing privileges” according to according to VieraCPA Healthcare Accountants in Miami.

Note that this recertification is also required for clinics and group practices. And, as you might expect, Healthcare Accountants in Miami anticipate that the notifications for the physicians in a large group practice might arrive in a “piece meal” manner. Diligence is required on behalf of you and your staff to avoid having your Medicare billing privileges deactivated, says VieraCPA Healthcare Accountants in Miami.

New Federal poster Requirements

The notification goes into further discussions regarding Healthcare Accountants in Miami what it is illegal for an employer to do, as well as what it is illegal for a union that represents an employee to do.

Healthcare Accountants in Miami experts say the background to this situation is that this is actually a rule put forth by the National Labor Relations Board. It was not passed by the Congress nor was it signed by the President.

What does this do to Your Practice?

What this does is effectively inform your employees that they do have the right to organize. It is widely understood that the Service Employees International Union (SEIU) has specifically targeted the Southeast, where there are a number of right to work states, with the intent of organizing. The healthcare industry, being obviously a significant service industry, is one of the key targets, according to Healthcare Accountants in Miami experts VieraCPA.

This being said, understand that if an employer knowingly and willfully even fails to post the notice, the failure may be considered as evidence of unlawful motive in an unfair labor practice case. The recommendation is that you watch for any implementation delays (there are a number of legal challenges of this requirement) and, assuming no change comply by Monday, November 14th. As practices become larger and larger due to mergers and other consolidations, it may inevitable that at some point or another, unions may approach your employees, or your employees approach unions.

HIPAA Enforcement Intensifies

The implementation of the HITECH Act under the ARRA in early 2009, and the recent refining of the regulations related to the enforcement of HIPAA by the Office of Civil Rights (OCR), has increased the scrutiny that healthcare organizations may undergo. In July 2011, the Office of Civil Rights awarded $9.2 million dollars to KPMG to conduct HIPAA compliance audits under the guidance of the Department of Health and Human Services staff. Under this program, there will be 150 audits varying in size and scope.

Of note in the discussion surrounding this project is the fact that most of the significant violators of late have been major institutions.

For example, UCLA Medical Center, Massachusetts General Hospital, and Cignet Health of St. George County Maryland. Mainly because of the publicity focused around HIPAA violations in national news coverage, there appears to be an increased awareness on the part of the general public about it. From January 1, 2010 thru December 31, 2010 there were 9,158 HIPAA complaints reported to the Office of Civil Rights nationally. Of those, 54% were resolved after intake and review. Of the remaining 4,229 cases that required investigation, in 2,703 (64%) the OCR required corrective action.

It’s worth taking a look at how this process works. As to how important cooperation is, in the case of Cignet, mentioned previously, $3 million of their $4.3 million fine was related to the fact that they failed to cooperate with OCR’s investigation on a continuing daily basis. This was perceived by the OCR as a willful neglect on behalf of Cignet to comply with the Privacy Rule.

Additional guidance will be forthcoming from CMS regarding specific issues related to the enforcement of the Security Rule under the HITECH Act. Look for this information to be published by CMS in the fall of 2011.

The Office of Civil Rights is seriously taking into account the severity of any privacy or security breach. There is what is known as a “threshold risk of harm” analysis that requires four steps. These are as follows:

  •  What was the nature of the data elements breached?
  • What is the likelihood that the information is accessible and usable?
  • What is the likelihood that the breach may lead to harm?
  • What is the ability of the covered entity to mitigate the risk of harm?

Some of the many breaches that have occurred have related, for example, to the theft of laptops containing protected health information (PHI). In many of these cases, the nature of the elements breached was significant in that it related to PHI. However, the likelihood that the breach could lead to harm was minimal due to the security systems that had been implemented and enforced. Simply stated, it was likely the thieves wanted the laptop and had no interest whatsoever in the PHI that it contained.

In fact, in some cases, the laptops have been recovered at pawn shops, etc. by law enforcement agencies and the covered entity has determined that the information was never accessed.

Healthcare Accountants in Miami VieraCPA are always available to assist you with questions related to the enforcement of HIPAA. Over the past few years we have had a number of situations in which our clients have been involved in breaches of PHI. Many of these were simply violations of common sense, others were due to carelessness. Fortunately we can state that none of them were done in a vindictive or truly harmful manner. Nonetheless, you need to be vigilant, constantly train your staff and keep them updated on HIPAA requirements.

Also be aware that a number of government agencies are involved in HIPAA enforcement. Aside from the HHS Office of Civil Rights, the Federal Trade Commission Bureau of Consumer Protection, the Centers for Medicare and Medicaid Services, as well as the Attorney General in your state may become involved.

Categories
Medicare

Miami Home Healthcare Accountants Bad Debt Recovery

Miami Home Healthcare Accountants Bad Debt Recovery

Miami Home Healthcare Accountants Gustavo A Viera CPA we’re concerned as the economic recession continues and with the rise in unemployment, Home Healthcare Accountants must deal with accelerated growth in bad debts in addition to the myriad of other financial and operating challenges presented during the downturn. Home Health Agency Accountants understand that while all bad debts cannot be recovered, 70% of allowable Medicare bad debt claims, including Medicaid cross-over balances, can be salvaged through the filing of a Medicare Cost Report.

CMS Home Healthcare Accountants define allowable bad debt in Provider Reimbursement Manual, Part I, Section 308 as debt that meets the following criteria:

The bad debt must be related to covered services and derived from deductible and coinsurance amounts.

  • The provider must establish that reasonable collection efforts were made.
  • The debt was actually worthless at the time of write-off.
  • There is no likelihood of recovery of the debt in the future.

Recent CMS Home Healthcare Accountants rulings provide some clarification regarding these criteria.  If the services of the Home Healthcare Accountants or clearing house are used by a facility, those bad debt claims must be returned to the facility and collection efforts discontinued before the debt is deemed “worthless”.  The Home Healthcare Accountants rulings also suggest that Home Healthcare Accountants Firms or clearing houses must treat Medicare Cost Report claims in a similar manner.

To mitigate any potential adjustments or reductions in Home Healthcare Accountants Medicare reimbursement during the annual audit of the Medicare Cost Report, Home Health Agencies Accountants should take the time beforehand to carefully review and analyze their bad debt logs. If you have any questions or concerns about your bad debt listings and would like more information on VieraCPA Home Health Agency Accountants bad debt review services, please call us.

As the largest operating division of HHS, the Centers for Medicare and Medicaid Services (“CMS”) undergoes multiple scheduled program reviews by the OIG.  As such, the Work Plan outlines the following areas of CMS evaluation:

  • Hospital Capital Payments – The OIG will evaluate Medicare reimbursement to hospitals for capital expenditures (facilities and equipment) for appropriateness.
  • Hospital Wage Data – Hospitals will be evaluated on the accuracy of wage data reported to CMS.  Specifically, because the wage data reported is used to calculate wage indices for the Inpatient Prospective Payment System (“IPPS”), appropriate representation of this data remains critical.
  • Critical Access Hospitals – The OIG will analyze payments made to Critical Access Hospitals; and, hospitals will additionally be evaluated on their ability to meet the criteria which defines a critical access hospital.
  • Medicare Disproportionate Share Payments – OIG will (i) evaluate Medicare disproportionate share payments made to qualifying hospitals and (ii) analyze the total amount of uncompensated care at these hospitals.
  • Hospital Readmissions – The OIG plans to assess trends related to hospital readmissions.  Specifically, oversight in same-day readmissions will be critically reviewed.
  • Diagnostic Imaging – According to CMS, increased use of diagnostic imaging services has proliferated during recent years.  As such, evaluations on potential overuse and service costs will be conducted.
  • Unbundled Laboratory Tests – The OIG plans to assess clinical laboratories which have unbundled laboratory tests to increase Medicare payments.  Specifically, the extent of this inappropriate unbundling will be evaluated by analyzing claims data.
  • Physician Reassignment of Benefits – Pursuant to the Social Security Act, physicians are not allowed to reassign Medicare beneficiaries except in the case of a specific exception. As such, the OIG will analyze reviews of such reassignments.  In addition, an examination of physicians’ awareness of these reassignments will reveal the extent of these occurrences.
  • Physician Identifier Number – The OIG plans to review Medicaid claims associated with invalid or inactive Physician Identifier Numbers; primarily, numbers used on claims after a physician’s death.
  • Managed Care Organizations (“MCO”) – MCO’s will be evaluated based on Federal standards regarding fraud and abuse safeguards and marketing practices.
  • Provider-Based Status – OIG plans to compile cost reports for hospitals claiming provider-based status for both inpatient and outpatient facilities.  Based upon such reports, it will then identify hospitals improperly claiming provider-based status for facilities.
  • Physician Hospice Billing – Based upon the standard that physicians should receive payments for hospice services solely under the Medicare Part B Physician Fee Schedule, the OIG will conduct reviews to identify whether physicians are double-billed (under Medicare parts A and B) for such services.

Physician Self-Referral for Durable Medical Equipment – OIG will conduct analyses to review the legality of physician referrals to durable medical equipment suppliers in which the physician holds ownership.

Given the aforementioned items, Home Health Agency Healthcare Accountants and physicians should assess both operational and financial relationship matters in order to ensure proper compliance moving forward into 2010.

Categories
Accounting

Healthcare Accounting FASB Updates

Miami Healthcare Accounting Publishes FASB Updates

Current healthcare accounting practices and health care entities recognize patient service revenue at the time the services are rendered regardless of whether the entity expects to collect that amount. Stakeholders raised concerns that such health care accounting practices result in a gross-up of patient service revenue and the related provision for bad debts, according to Healthcare Accountants VieraCPA. Additionally, because health care entities make their own judgments regarding adjustments to revenue and bad debts, those judgments are different from one health care entity to another and comparability is impaired, making analysis difficult for healthcare accounting and financial statement users.

The objective of this Update is to provide financial statement users with greater transparency about a health care accounting entity’s net patient service revenue and the related allowance for doubtful accounts. This Update provides information to assist healthcare accountants and financial statement users in assessing an entity’s sources of net patient service revenue and related changes in its allowance for doubtful accounts. The amendments in healthcare accounting require health care entities that recognize significant amounts of patient service revenue at the time the services are rendered even though they do not assess the patient’s ability to pay to present the provision for bad debts related to patient service revenue as a deduction from patient service revenue (net of contractual allowances and discounts) on their statement of operations.

Healthcare Accounting Who Is Affected by the Amendments in This Update?

The amendments in this Update affect entities within the scope of Topic 954, Health Care Accounting, that recognize significant amounts of patient service revenue at the time services are rendered even though the entities do not assess a patient’s ability to pay. All other entities would continue to present the provision for bad debts (including bad debts associated with patient service revenue) as an operating expense.

What Are the Main Provisions?

The amendments in this Update require healthcare accountants to change the presentation of their statement of operations by reclassifying the provision for bad debts associated with patient service revenue from an operating expense to a deduction from patient service revenue (net of contractual allowances and discounts). Additionally, healthcare accounting entities are required to provide enhanced disclosure about their policies for recognizing revenue and assessing bad debts. The amendments also require disclosures of patient service revenue (net of contractual allowances and discounts) as well as qualitative and quantitative information about changes in the allowance for doubtful accounts.

How Do the Main Provisions of Healthcare Accounting Differ from Current U.S. Generally Accepted Accounting Principles (GAAP) and Why Are They an Improvement?

The Health Care Accounting amendments in this Update change the presentation of the statement of operations and add new disclosures that are not required under current GAAP for entities within the scope of this Update. The provision for bad debts associated with patient service revenue for certain entities is required to be presented on a separate line as a deduction from patient service revenue (net of contractual allowances and discounts) in the statement of operations. This change in the presentation of the statement of operations will be an improvement from current GAAP because it will result in the presentation of an amount of net patient service revenue (after any provision for bad debts) that is closer to the amount that the health care entity expects to collect, according to Healthcare Accountants VieraCPA. The new disclosures will assist users of financial statements to better understand how health care entities recognize patient service revenue and assess bad debts.

When Will the Amendments Be Effective?

For public entities, the healthcare accounting amendments in this Update are effective for fiscal years and interim periods within those fiscal years beginning after December 15, 2011, with early adoption permitted. For nonpublic entities, the health care accounting amendments are effective for the first annual period ending after December 15, 2012, and interim and annual periods thereafter, with early adoption permitted. Healthcare accountants adopting the amendments to the presentation of the provision for bad debts related to patient service revenue in the statement of operations should be applied retrospectively to all prior periods presented. The disclosures required by the amendments in this Update should be provided for the period of adoption and subsequent reporting periods.

How Do the Healthcare Accounting Provisions Compare with International Financial Reporting Standards (IFRS)?

IFRS does not currently require similar presentation or disclosures as set forth in the amendments in this Update. However, the Boards recently completed redeliberations on an Exposure Draft, Revenue Recognition (Topic 605): Revenue from Contracts with Customers. In redeliberations of that Exposure Draft, the Boards tentatively decided to present impairment losses (that is, bad debts) from contracts with customers as a separate line item adjacent to the revenue line item (as contra revenue), consistent with the provisions of this Update. In addition, the Boards tentatively decided that disaggregated revenue information should be disclosed. The Boards plan to reexpose the tentative decisions reached in redeliberations of that Exposure Draft in the second half of 2011.

 

Categories
Business Trends

Sample Healthcare Business Plan

Healthcare Business Plan

For application of licensure with AHCA and certification with Medicar

As Miami Healthcare Accountants specializing in Healthcare Accounting, we prepare custom Healthcare Business Plan for startup Home Healthcare Agencies or Change of Ownership. VieraCPA have been Healthcare Accountants for more than 20 years. We provide a wide range of Healthcare Accounting services to HHA throughout Florida.

AHCA now requires a Healthcare Business Plan along with the Proof of Financial Ability to Operate for new HHA’s or change of ownership to be prepared by a CPA. The Healthcare Business Plan requires very specific knowledge of healthcare accounting which our Healthcare Accountants are diligent in keeping up with every new law.

We have prepared a partial sample Healthcare Business Plan to help Home Healthcare Agency owners understand the requirements and in depth analysis required by AHCA. The Healthcare Business Plan should start with the Executive Summary.

“EXECUTIVE SUMMARY”

XYZ Corp. is a Home Healthcare Agency, organized on June 1, 2011 as a private for profit corporation looking to be licensed by AHCA in Florida and certified by Medicare and Joint Commission accredited.

XYZ Corp. is planning on operating a Home Health Agency in the Miami-Dade Area and licensed by AHCA in Florida and certified by Medicare and Joint Commission accredited.

The initial capital contribution, as calculated on Form 3100-0009 AHCA Proof of Financial Ability to Operate, is $000,000 to be deposited in full prior to submission of licensed by AHCA in Florida and certified by Medicare and Joint Commission accredited, prepared and signed by a Healthcare Accountants CPA. (read more….)

The Healthcare Business Plan should continue with the objectives and mission statement section which looks something like this:

“OBJECTIVES”

The objectives of the company are:

1)      Recruit and train a specialized technical force to provide Skilled Nursing, Therapies and Home Health Aide services beyond the expected standard.

2) Develop among the company personnel a culture of efficiency, work quality and personal responsibility on service rendered.

“MISSION”

XYZ Corp. is dedicated to providing quality home health care and other health services to patients in Florida, offering a high level of professionalism, efficiency and compassion; complementing services provided by hospital, doctor’s clinics and other health institutions that require home care.

Next we have to get into the nuts and bolts of Healthcare Accounting and projected revenue streams:

“SERVICES TO BE PROVIDED”

The company plan to offer the following services:

a) Skilled Nursing at RN and LPN level

b) Home Health Aide and CNA

c) Physical Therapy

d) Occupational Therapy

e) Social Worker Services

f) Speech Therapy

The Market Analysis is the most complex and where we as Healthcare Accountants with over 20 years of Healthcare Accounting experience really add value. The Healthcare Business Plan market analysis data is statistical in nature. Here is a sample:

“MARKET ANALYSIS”

The State of Florida has, an estimated population of 18,801,310 in 2010: from this total about 17.2 % are 65 or older (U.S. Census Bureau, Quick Facts).

However, projections show that that percentage will grow even more 13.82% by 2015 and 2030 (taken from Data on County Aging Services Needs Assessment, University of South Florida, October 3, 2007), even the Florida state general population rate of increase in the last 8 years was over 14.7% and the above mentioned projection foresees a growth of over 15% from 2000 to 2010. It is our conclusion that the market for serving the needs of older population (those over 65) will have an increase in demand in these Counties in the next 5—10 years.

The Healthcare Business Plan continues with Level of Competition, Market Strategy, Timeline, Personnel, Recruiting & Retention Strategy, Admission Policies and more.

If you’re thinking about starting or buying an HHA, give us a call for a free initial consultation.

Good Luck!

Gustavo A Viera CPA

 

Categories
Accounting

Healthcare Accounting: Managing Cash Flow

Healthcare Accounting: Managing Cash Flow

Healthcare accounting is complex and cash flow management is a process of best practice which involves; forecasting cash needs, providing idle funds, calculating disbursements, covering shortfalls, collecting payments, and reimbursing banks for all these actions by your Healthcare Accountants.

Cash flow management involves tax and healthcare accounting evaluation. Therefore, every business requires best practice involving staff handling tax and healthcare accounting by their healthcare accountants. Additionally, there is need for coordination between the staff in the treasury, healthcare accounting and operations department. These best practices along with powerful electronic tools assist in collection of data on financial information and formatting. This is necessary for generation of reports to help healthcare accountants and managers in making decisions.

In order to facilitate best practices in managing cash flow there are some important steps which can be taken. These include:

Selecting a Healthcare Accounting Firm:

When companies shop for the right Healthcare Accountants for support with cash management they tend to look for quality of services rather than low cost. Healthcare Accountants therefore offer their business clients with Electronic Data Interchange (EDI) and automated processes. Automated processes may be payrolls and account payables and others. This ensures security against theft as well as affordable healthcare accounting outsourcing option for organizations. This is one of the reasons why Healthcare Accountants consolidate their accounts with few firms and are not dependent on a single healthcare accounting as a best practice.

Models for Accurate Cash Forecast:

There is a lot of uncertainty about cash flow. This is why Healthcare Accountants use forecast models as best practice to assist them with disbursements. Forecasts are made based upon the daily, monthly, seasonal, and cyclic patterns and trends. There are three forms of forecasts to help companies in assessing how well it fares;

  •  Short term: covering 1 day to 2 weeks
  •  Medium term: a few weeks, 1 year or may be 2 years
  •  Long term: covering 1 year, 2 years or more

The best healthcare accounting practice most Healthcare Accountants ensure is to use the “rolling format” which continuously updates incoming receipts and assists in disbursements. Additionally, this increases accuracy of forecasts and assists the company in “cash critical periods.”

Maximized Investments:

It is a best healthcare accounting practice for Healthcare Accountants to have clear, transparent investment policies indicating their objectives, guidelines and acceptable investments. These assist managers in making decisions according to opportunities. The aim is to increase yield of investments at low costs. Additionally, companies use Sweep accounts.

These are effective because they allow companies to “sweep” or move the idle cash into overnight investments at the end of the day. Sweep accounts allow companies to use zero balance accounts to write checks and drafts without penalty charges. The amount of money is drawn from central accounts to make payments for the company.

Regular Cash Management System Review:

Identifying weak areas in a company’s healthcare accounting is a best practice which helps in improving the cash management system. This provides the assurance that the company’s financial data is reliable and accurate without the need for an audit. Therefore, this best practice ensures that collection and payment processes are reviewed regularly for evaluation of cash flow and its management.

Cash flow Management is one of the most effective and recommended best practices. It is necessary because it ensures accurate audit reports and annual financial statements of businesses and other financial institutions.

Categories
Medicare

Healthcare Accounting & Medicare Cost Report

Healthcare Accounting & Medicare Cost Report

Within the last 25 years our Healthcare Accounting Service in Miami have prepared hundreds of Medicare Cost Report and our commitment to Healthcare Accounting Service has grown stronger as the financial changes have forced the healthcare industry to look past their primary objective, that of providing care, to that of earning a living.

Our Healthcare Accounting Service abilities will aid the preparation of a tax return and especially Medicare Cost Report. Tax & Medicare laws are complicated and filled using exceptions to every regulation. Most clients do not know if the return is wrong and right, and it may well not matter since defending an audit, even if you are 100% correct, can cost you thousands of dollars. In many cases, different Healthcare Accounting Service will discover things differently and get different conclusions good facts of your go back. The most important thing is that you understand what is on the return. The IRS & MEDICARE get increased the fines and penalties for return errors plus its becoming increasingly more complicated to arrange a return or Medicare Cost Report.

We’ve had clients who prepare their own Medicare Cost Report, come to him after the Medicare has suspended billing during a review.

Healthcare Accounting Service

Our Healthcare Accounting Service are precisely that – healthcare accountants. With Gustavo A Viera CPA you will be assured that your Medicare Cost Report company has significant, relevant experience with healthcare providers like you. Your Healthcare Accounting Service team will involve individuals who spend virtually all of their professional time serving that healthcare industry – not necessarily manufacturing, retail or some other industries.

Viera provides audit and Healthcare Accounting to healthcare entities ranging in dimensions from small physician practices and ancillary providers to help multi-state integrated healthcare organizations with assets for longer than $1 billion. This experience across the spectrum of healthcare enables Healthcare Accounting Service to quickly identify the financial reporting areas of greatest risk to your small business and to more efficiently and effectively perform audit or accounting services. Further, our Healthcare Accounting Service teams are structured providing our senior executives more hours with our clients so as to provide the hands on encounter and oversight.

The following can be a partial listing of the categories of audit and Healthcare Accounting solutions Gustavo A Viera CPA offers our clients:

· Audits, feedback, and compilations of fiscal statements

· Audits in acquiescence with Government Auditing Principles and OMB Circular A-133

· Internal control reviews and risk assessments

· Impairment testing of intangible possessions

· Agreed-upon procedure reports together with special reporting

· Transaction accounting assistance, including allocation of final cost

· New accounting standard setup

· Outsourcing of inside audit functions

· Accounting insurance coverage and procedure manual advancement

As Healthcare Accounting Service dedicated to serving the healthcare market (over 75% of our revenues are healthcare related), we have available that resources to supplement the extensive knowledge of our Healthcare Accounting Service through the use of our dedicated reimbursement, scientific and healthcare tax sections. Our relationships with loaning institutions, bond underwriters and rating agencies are in a way that Viera is a nationally recognized Healthcare Accounting Service in connection with debt issues.

Our Medicare Cost Report consults practices and healthcare related small businesses at every stage with the business cycle across that spectrum of medical areas and allied fields. We help you to increase income, reduce costs and increase client/patient satisfaction.

Categories
Medicare

Healthcare Accountants and New OASIS Requirements for Accredited HHAs Seeking Medicare Certification

Healthcare Accountants wanting to become Medicare approved must seek guidance from their respective State Survey Agency

Any HHA seeking Medicare certification is required to meet the Medicare Conditions of Participation (CoP) prior to certification. This includes compliance with the OASIS collection and transmission requirements. New HHAs Healthcare Accountants must demonstrate that they can transmit OASIS data prior to the initial certification survey. Specifically, new HHAs Healthcare Accountants must apply for a user identification number and password to electronically transmit to the OASIS State System any encoded Start of Care (SOC) or Resumption of Care (ROC) OASIS assessment record(s) for applicable Medicare and Medicaid patients in a test mode. New HHAs Healthcare Accountants should communicate with the OASIS Automation Coordinator (OAC) in their state to comply with this aspect of the Medicare requirements prior to the initial onsite survey.

To meet the OASIS transmission requirements prior to the initial certification survey, new HHAs Healthcare Accountants need two different sets of user identification numbers and passwords; one set to access the CMSNet and one set to access the OASIS State System.

The CMSNet is a private communications network which allows data submitted to the OASIS State System to be encrypted during the transmission process precluding any unauthorized sources from intercepting identifiable data. The HHA must apply for a user identification number and password for access to the CMSNet by contacting the CMSNet Help Desk at 1-800- 905-2069. New HHAs Healthcare Accountants need to install the communications software, which is separate from the Home Assessment Validation Entry (HAVEN) software, which will allow them to access the CMSNet.

The new HHA must register for an individual user identification and password to access the OASIS State System. The HHA must complete and submit the OASIS Individual User Account Request form which is available on the QIES Technical Support Office (QTSO) website at the web link under Related Links Outside CMS.

The OAC in each SSA should assist the new HHA in obtaining the user identification number and password for CMSNet and guide HHAs Healthcare Accountants through registration for an individual user identification and password for access to the OASIS State System prior to the initial certification survey.

Once the communications software and access are in place, the new HHA must demonstrate that it can transmit OASIS data to the OASIS State System by (1) making a test transmission of any SOC or ROC OASIS data that passes CMS edit checks; and (2) receiving validation reports back from the OASIS State System confirming data transmission. The OAC in each state can assist new HHAs Health care Accounting Service with this process.

Determining Compliance with the OASIS Transmission Requirements

The OAC at the SSA can determine the Healthcare Accountants compliance with the OASIS transmission requirements from their locations; however, the HHA should maintain all copies of validation reports for its own records.

If the new HHA chooses to independently transmit OASIS data from its own office, the State HHA survey team and the OAC must communicate with each other to establish that the new HHA has successfully transmitted test OASIS data using the appropriate user identification numbers and passwords prior to onsite survey. The HHA should maintain all copies of the validation reports for its records.

If the new HHA chooses to use a software vendor to meet the OASIS encoding and/or transmission requirement on its behalf, the HHA must still establish connectivity to the state system via the software vendor. The HHA should have a written contract that describes this arrangement. The vendor must apply for access to the new agency as a Third Party submitter. Forms are available on the QTSO website at www.qtso.com. The HHA or its software vendor must contact the OAC and CMSNet Help Desk for the appropriate user identification numbers and passwords to establish connectivity with the OASIS State System. The HHA should obtain copies of all validation reports from its software vendor for its records.

If the new HHA chooses to use another certified HHA to meet its transmission requirements, for example, another established HHA in the chain or other established but non-related HHA, the HHA must still demonstrate connectivity to the state system via the other established certified HHA. The new HHA or other HHA must contact the OAC and CMSNet Help Desk for the appropriate user identification numbers and passwords in order to establish connectivity with the OASIS State System. The new HHA must have clearly written policies outlining the procedures in place with the other HHA with regard to OASIS collection, encoding, and submission to the OASIS State System and the sharing of feedback reports from OASIS State System with the new HHA.

HHAs Healthcare Accountants Seeking Initial Certification Through an Approved Accreditation Organization (AO) with Deeming Authority

An HHA may choose to obtain initial Medicare certification by electing the deemed status option through an approved AO that has been granted deeming authority for Medicare requirements for HHAs Healthcare Accountants. There are currently three AOs with deeming authority for HHAs Healthcare Accountants: The Joint Commission, the Community Health Accreditation Program and the Accreditation Commission for Health Care, Inc.

HHAs Healthcare Accountants seeking initial certification through the deemed status option must install the necessary communications software and contact the SSA and CMSNet Help Desk for the appropriate user identification numbers and passwords in order to demonstrate compliance with OASIS submission requirements prior to approval.

Exceptions to Demonstrating Compliance with OASIS Submission Requirements Prior to Approval

New HHAs Health Care Accountants that intend to admit or treat only patients to whom OASIS currently does not apply, i.e., patients under 18, maternity, and patients receiving only unskilled care or chore services are not expected to demonstrate compliance with OASIS submission requirements prior to approval.

These HHAs Healthcare Accountants must attest this intention to the SSA. After certification, if there is a change in the HHAs Health Care Accountants policies that includes the acceptance of patients to whom OASIS applies, the HHA is expected to install the necessary communications software and contact the SSA and CMSNet for the appropriate user identification numbers and passwords.

Initial Surveys

State Survey Agencies and AOs will not schedule initial surveys until the SSA or AO has determined the HHAs Healthcare Accountants status with the OASIS transmission requirement. HHAs Healthcare Accounting Service and AOs may contact the state OAC directly to determine the status of the new HHA’s activities concerning the OASIS transmission process prior to scheduling the onsite survey. The names and phone numbers of the OACs can be found at the web link Related Links Inside CMS.

 

Categories
Accounting

Healthcare Accounting Services and Health Information Systems (IT)

Healthcare Accounting Services and Health Information Systems (IT)

Healthcare and all the political hype about Obama Care hаs become а fundamental pаrt оf оur day-to-day lives. But Healthcare Accounting Services has always been the engine keeping the healthcare sector on the right track. Thіs hаs bееn а result оf thе massive positive impact thаt niche CPA Firms and Healthcare Accounting Services hаve hаd іn healthcare.

Healthcare Accounting Services cаn bе improved thrоugh Health Information Systems (IT) іn various ways. It іs beneficial tо both patients аs wеll аs medical practitioners. Healthcare Accounting Services utililize healthcare software solutions that аrе cost-effective; provide centralized management оf patient records, billing, financial management аnd оthеr key aspects related tо Healthcare Accounting Services and  management. Thus, besides managing patient records, Healthcare Accounting Services/medical practitioners cаn benefit frоm software tо manage аnd organize thеіr business.

Administratively, іt hеlps іn preventing errors, whіch wеrе mоst probably а bіg headache іn thе traditional paperwork environment. Creating medical bills, recording patient profiles аnd generating piles аnd piles оf medical files wеrе vеry hectic аnd error-prone. However, an efficient Healthcare Accounting Services wіth healthcare software, оnе cаn expect smooth healthcare management, wіth minimal mistakes іf аny. It enhances thе level оf productivity thrоugh tіmе saving whіlе creating bills, invoices, balancing accounts, recording patient reports etc.

Healthcare software systems all-in-all bring аbоut an increase іn quality оf thе service delivered by Healthcare Accountants аnd bring аbоut efficiency gains within thе organization; promoting patient safety, upgrading security protocols, electronic health records, computerized provider order entry. Besides thіs, electronic billing аnd claims submission rapidly generate additional savings by decreasing thе costs оf creating bills аnd speeding reimbursement.

Many healthcare software solutions incorporate features such аs administrative billing аnd financial general ledger, cost accounting systems, patient registration, personnel аnd payroll, electronic materials management, clinical computerized provider order entry fоr drugs, lab tests, procedures, electronic health record, picture archiving аnd communication systems, filmless imaging, results reporting оf laboratory аnd оthеr tests, clinical decision support systems, prescription drug fulfillment, error-alert, transcriptions, electronic monitoring оf patients іn intensive care, units, іt infrastructure such аs desktop, laptop, аnd tablet computers, servers аnd networks, wireless networks, voice recognition systems fоr transcription, physician orders, аnd medical records, bar-coding technology fоr drugs, medical devices, аnd inventory control, information security systems, physicians, administrative billing, аnd financial accounting, scheduling, clinical online references (drug compendia аnd clinical guidelines), receiving lab results аnd оthеr clinical information, online, electronic prescribing, computerized provider order entry, clinical decision support systems, electronic health record, e-mail communication wіth patients infrastructure desktop аnd laptop computers handheld technology servers аnd network.

Categories
Medicare

Healthcare Accountants Concerned About Provisions In The American Taxpayer Relief Act

Healthcare Accountants closer inspection of the American Taxpayer Relief Act significant shows implications for the healthcare industry.

In late night action on December 31, 2012, the American Taxpayer Relief Act of 2012 (ATRA) was passed by the Senate and finalized days later by Congress and the President with a set of tax and spending policy provisions intended to provide relief to the American taxpayer — avoiding the “fiscal cliff” set up by the Budget Control Act of 2011. Upon closer inspection by our Healthcare Accountants, however, the ATRA also has some important implications for the healthcare industry and sets the stage for future healthcare spending reductions and appropriations discussions in 2013. Healthcare Accountants Gustavo A Viera CPA offers a brief overview of the ATRA’s good, bad and ugly provisions for the healthcare industry.

The Good

One of the largest issues looming over Congress relating to Medicare involved the fate of the sustainable growth rate (SGR) impending statutory cuts of nearly 27 percent, which would have further exacerbated the Healthcare Accountants shortage currently experienced in the Medicare program and was widely criticized. The ATRA addressed this issue, but once again, only did so for a short time. At a cost of $25 billion, the ATRA froze existing Medicare physician rates at their current level through 2013. This means that the SGR fight to obtain permanent relief will continue during 2013.

Healthcare Accountants Gustavo A Viera CPA  points out the impending Budget Control Act sequester which would have included a mandatory two percent Medicare provider rate cut, reductions in important discretionary spending programs such as the National Institutes of Health (NIH) and graduate medical education programs is delayed for two months.

Other Medicare reimbursement and healthcare programs Healthcare Accountants not are set to expire on December 31, 2012, were extended, including the Medicare physician work geographic adjustment and certain Medicare programs necessary to sustain ambulance service and Medicare dependent individuals in rural areas. Medicare payment changes for outpatient therapy services at hospitals were also addressed.

Funding for low-income outreach and assistance programs and the Medicaid qualified individual and transitional assistance programs were extended. Similarly, the ATRA reauthorized the Medicaid and Children’s Health Insurance Program express lane option program through September 30, 2014.

The Bad

Healthcare Accountants point out the major issues that hung in the balance with regard to healthcare spending during last year’s fiscal cliff negotiations remain unresolved, and the ATRA added upwards of $4 trillion to the deficit over the next ten years. As Congress continues to grapple with the nation’s fiscal woes in the coming months, spending reductions in healthcare remain in the crosshairs.

Medicaid disproportionate share hospital (DSH) payments will be rebased to extend the anticipated Affordable Care Act (ACA) reductions from 2021 to 2022. The rebasing of DSH payments is expected to provide up to $4.2 billion in savings over ten years.

Bundled payments for end stage renal disease will be rebased. Incorporating recommendations from Healthcare Accountants relating to reductions in oral drugs and biologics, the payment reduction for renal dialysis services is anticipated to achieve $4.9 billion in savings.

The ATRA rescinds unobligated funds for the ACA’s Consumer Operated and Oriented Plan (CO-OP) program to the tune of approximately $2.3 billion.

Also as discussed in detail in the article that follows, the ATRA significantly alters provider rights related to overpayment recoupment, refunds, audits and claims appeals.

The Ugly

Overall healthcare industry spending continues under the microscope and, as Congress prepares over the next several months to make significant headway on cost reductions, entitlement reform will rank high on the nation’s agenda. Consequently, Medicare, Medicaid, discretionary programs, research and graduate medical education all will be targets for spending reductions. Creative solutions to save money and continue coverage for individuals will be sorely needed. Healthcare Accountants will want to be at the table to ensure that provider reimbursement, the first at the chopping block, will not be the sole mechanism that Congress employs to reduce healthcare spending in the budget battles ahead.